Jonas J. Swartz, MD, Oregon Section Junior Fellow vice chair
I had the pleasure of representing the Oregon Section at the ACOG Congressional Leadership Conference, The President’s Conference, in Washington, DC, March 3–5, with Marguerite P. Cohen, MD, Oregon Section chair; Stella M. Dantas, MD, District VIII secretary; Nicole E. Marshall, MD, District VIII young physician; Peter E. Palacio, MD, immediate past Oregon Section chair and legislative chair; and Eric F. Warshaw, MD, Oregon Section vice chair.
Together, we spoke with Oregon representatives and senators about several issues on ACOG’s national agenda. We asked members of Congress to support three bills introduced this legislative session: the Medicare Physician Payment Innovation Act, Quality Care for Moms and Babies Act, and Women’s Health Resolution.
The Medicare Physician Payment Innovation Act would repeal the Medicare sustainable growth rate (SGR) and instead support quality-based systems that reward high value care. Congress enacted SGR in 1997 as a way for the Centers for Medicare and Medicaid Services to control yearly expenditures. SGR is designed to keep yearly increases in Medicare spending tracking with growth in the gross domestic product (GDP). If Medicare expenditures increase less than the yearly increase in GDP, payments for physicians increase. If Medicare expenditures grow at a rate exceeding GDP, payments for physicians decrease.
When SGR was passed by Congress, lawmakers and health care leaders could not have anticipated the large scheduled payment reductions that would result. If allowed to trigger, for example, physicians would face a scheduled reduction of 30% in Medicare payments on January 1, 2014. Currently, Congress passes yearly fixes, which protect reimbursement for a single year. SGR repeal would allow our system to move forward with quality-based payment reform without the threat of slashing reimbursement.
The Quality Care for Moms and Babies Act would provide funding to establish and expand quality care perinatal collaboratives in each state. Many states, including Oregon with its Obstetric and Pediatric Research Collaborative, are already collecting statewide outcomes data. Some states, including Washington, Ohio, and Tennessee, have used these networks to help decrease inductions prior to 39 weeks’ gestation, neonatal intensive care unit (NICU) visits, and cesarean deliveries. They have also used them to increase human milk use in the NICU. Early results demonstrate that the collaboratives have the potential to both improve care and save money. Read more about the Washington State Perinatal Collaborative.
The Women’s Health Resolution lists legislative threats to women’s health at state and national levels, which were rampant in the last election cycle. These threats include bills proposed and passed to restrict full spectrum reproductive choice, mandate unnecessary tests such as transvaginal ultrasounds, and repeal the Affordable Care Act. Generally, the Women’s Health Resolution seeks to keep Congress out of the patient-provider relationship. However, it also draws attention to the detrimental trend toward legislative mandates based on fuzzy science.
We were appreciative that Sen. Jeff Merkley (D-OR), Rep. Greg Walden (R-OR), Rep. Suzanne Bonamici (D-OR), and staff from the offices of Sen. Ron Wyden (D-OR) and Rep. Earl Blumenauer (D-OR) took time to meet with our group and discuss these important issues.